The Femoral Trochlear Anterior Line is a Better Alternative Intra-operative Reference Compared to Femoral Anterior Tangent Line for Femoral Rotation in Both Genders in Total Knee Arthroplasty

Overview

Journal J Exp Orthop

Publisher Wiley

Specialty Orthopedics

Date 2020 Jun 10

PMID 32514814

Citations 1

Authors

Ji-Hoon Nam

Yong-Gon Koh

Paul Shinil Kim

KiWon Kang

Kyoung-Tak Kang

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine the most reliable reference axis for the femoral component rotation in TKA patients by comparing the trochlear anterior line (TAL) and the femoral anterior tangent line (FAT). To evaluate the variability of each anatomic parameter in a Korean population.

Methods: Magnetic resonance images (MRIs) were taken for 500 patients (400 females and 100 males) with knee joint osteoarthritis who had Kellgren and Lawrence grade 3 and 4 prior to TKA in our institution between February 2016 and September 2017. It was investigated that whether significant differences in variance and gender exist for TAL and FAT.

Results: TAL and the FAT were internally rotated by 5.1° ± 3.1° and 6.8° ± 6.1°, respectively, about the Transepicondylar axis (TEA). Although no gender-related differences were found for the TAL, they were found for the FAT. The variance of the TAL with respect to the TEA was significantly smaller compared with that for the FAT and thus exhibited a more consistent distribution. In addition, such a trend was found for both genders.

Conclusions: The results show that the TAL is a favorable index for appropriate rotational alignment of the femoral component in TKA.

Citing Articles

The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based study.

Li S, Deng H, Jiang L, Liang H, Sun J, Xu Y Front Surg. 2024; 11:1363551.

PMID: 38550792 PMC: 10972973. DOI: 10.3389/fsurg.2024.1363551.

References

Morizane K, Takahashi T, Konishi F, Yamamoto H . The anterior trochlear line as a reference for femoral component positioning in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2011; 19(12):2009-15. DOI: 10.1007/s00167-011-1401-8. View

Akagi M, Yamashita E, Nakagawa T, Asano T, Nakamura T . Relationship between frontal knee alignment and reference axes in the distal femur. Clin Orthop Relat Res. 2001; (388):147-56. DOI: 10.1097/00003086-200107000-00022. View

Watanabe H, Gejo R, Matsuda Y, Tatsumi I, Hirakawa K, Kimura T . Femoral anterior tangent line of the osteoarthritic knee for determining rotational alignment of the femoral component in total knee arthroplasty. J Arthroplasty. 2010; 26(2):268-73. DOI: 10.1016/j.arth.2009.12.011. View

Page S, Pinzuti J, Deakin A, Payne A, Picard F . Profile of the distal femur anterior cortex--a computer-assisted cadaveric study. Orthop Traumatol Surg Res. 2011; 97(8):821-5. DOI: 10.1016/j.otsr.2011.09.009. View

Matziolis D, Meiser M, Sieber N, Teichgraber U, Matziolis G . Posterior Cortical Axis: A New Landmark to Control Femoral Component Rotation in Total Knee Arthroplasty. Orthopedics. 2017; 40(3):188-190. DOI: 10.3928/01477447-20170117-01. View

Yoshino N, Takai S, Ohtsuki Y, Hirasawa Y . Computed tomography measurement of the surgical and clinical transepicondylar axis of the distal femur in osteoarthritic knees. J Arthroplasty. 2001; 16(4):493-7. DOI: 10.1054/arth.2001.23621. View

Olcott C, Scott R . A comparison of 4 intraoperative methods to determine femoral component rotation during total knee arthroplasty. J Arthroplasty. 2000; 15(1):22-6. DOI: 10.1016/s0883-5403(00)91051-9. View

Poilvache P, Insall J, Scuderi G . Rotational landmarks and sizing of the distal femur in total knee arthroplasty. Clin Orthop Relat Res. 1996; (331):35-46. DOI: 10.1097/00003086-199610000-00006. View

Miller M, Berger R, Petrella A, Karmas A, Rubash H . Optimizing femoral component rotation in total knee arthroplasty. Clin Orthop Relat Res. 2001; (392):38-45. DOI: 10.1097/00003086-200111000-00005. View

10.

Berger R, Rubash H, Seel M, Thompson W, Crossett L . Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res. 1993; (286):40-7. View

11.

Kamath A, Slattery T, Levack A, Wu C, Kneeland J, Lonner J . Trochlear inclination angles in normal and dysplastic knees. J Arthroplasty. 2012; 28(2):214-9. DOI: 10.1016/j.arth.2012.04.017. View

12.

Berger R, Crossett L, Jacobs J, Rubash H . Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res. 1999; (356):144-53. DOI: 10.1097/00003086-199811000-00021. View

13.

Ji H, Jin D, Han J, Choo H, Won Y . Comparison of alternate references for femoral rotation in female patients undergoing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2015; 24(8):2402-6. PMC: 4969333. DOI: 10.1007/s00167-015-3506-y. View

14.

Akagi M, Matsusue Y, Mata T, Asada Y, Horiguchi M, Iida H . Effect of rotational alignment on patellar tracking in total knee arthroplasty. Clin Orthop Relat Res. 2000; (366):155-63. DOI: 10.1097/00003086-199909000-00019. View

15.

Kang K, Kim S, Son J, Han Lee Y, Kim S, Chun H . Probabilistic evaluation of the material properties of the in vivo subject-specific articular surface using a computational model. J Biomed Mater Res B Appl Biomater. 2016; 105(6):1390-1400. DOI: 10.1002/jbm.b.33666. View

16.

Han H, Oh S, Chang C, Kang S . Anthropometric difference of the knee on MRI according to gender and age groups. Surg Radiol Anat. 2015; 38(2):203-11. DOI: 10.1007/s00276-015-1536-2. View

17.

Won Y, Cui W, Baek M, Yun T, Han S . An additional reference axis for determining rotational alignment of the femoral component in total knee arthroplasty. J Arthroplasty. 2007; 22(7):1049-53. DOI: 10.1016/j.arth.2007.02.005. View

18.

Loures F, Furtado Neto S, Pinto R, Kinder A, Labronici P, Goes R . Rotational assessment of distal femur and its relevance in total knee arthroplasty: analysis by magnetic resonance imaging. Radiol Bras. 2015; 48(5):282-6. PMC: 4633071. DOI: 10.1590/0100-3984.2014.0037. View

19.

ARIMA J, Whiteside L, McCarthy D, White S . Femoral rotational alignment, based on the anteroposterior axis, in total knee arthroplasty in a valgus knee. A technical note. J Bone Joint Surg Am. 1995; 77(9):1331-4. DOI: 10.2106/00004623-199509000-00006. View

20.

Uehara K, Kadoya Y, Kobayashi A, Ohashi H, Yamano Y . Bone anatomy and rotational alignment in total knee arthroplasty. Clin Orthop Relat Res. 2002; (402):196-201. DOI: 10.1097/00003086-200209000-00018. View